Glossary


Our Glossary makes important health related information easy to understand. So learn more about the medical terms that you come across everyday.

A

Abrasion

A surgically scraped or accidentally grazed area of skin, with little or no damage to the underlying tissue. Normally a superficial graze which is not deep or too serious.

Abscess

An abscess is a localised collection of pus that builds up under pressure and may eventually burst.

Acid reflux

At times the acid juices of the stomach well up in the lower part of the oesophagus. This acid reflux irritates the lining of the oesophagus and causes what is more commonly known as heartburn.

Acute medicine

Medicine that is typically used on a short term basis such as a course of antibiotics.

Acute Pain

Sudden onset of pain, which is usually brief but severe in nature.

Allergen

Allergens are substances that cause allergic reactions and may trigger the onset of asthma.

Allergy

When the body responds abnormally to a foodstuff or another substance this is indicative of an allergy or allergic reaction.

Analgesic

A type of drug / medicine that relieves pain.

Antacid

Excess acidity in the stomach may be reduced by an antacid which is an alkaline substance.

Anthelmintic

Medicine used to rid the body of worm infestations.

Antiemetic

A drug that reduces the incidence and severity of nausea and vomiting.

Antihistamine

An agent that prevents or treats an allergic reaction – see above.

Antipyretic

A drug that effectively reduces fever. The most commonly known and used antipyretic drugs are aspirin and paracetamol.

Antiseptic

A chemical that destroys bacteria. May be applied to the skin or other areas to prevent infection.

Antitussive

Effective agent in relieving coughs.

Ascorbic acid

Vitamin C.

Astigmatism

Faulty vision caused by an irregularly shaped cornea.

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B

Bacteria

Germs.

Benefit design

The decision about which procedures, medicines or ailments are considered for reimbursement by a Medical Scheme provided to patients as a guideline in terms of what their Medical benefit allows/covers for the year.

Beta carotene

Vitamin A (from plant foods).

Blepharitis

Inflammation of the eyelid margin.

Boil

A painful, swollen collection of pus caused by local bacterial infection.

Bronchodilator

A drug that opens up the bronchial tubes in the lungs which have become narrower due to muscle spasm. Without the bronchodilator action difficulty of breathing would be experienced.

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C

Calciferols

Vitamin D.

Calorie

This is the measure of a unit of food energy.

Cataract

Cataracts are a misting or clouding of the eye lenses which may result in blindness or loss of vision. Mostly caused by exposure to environmental elements such as free radicals and pollutants. Cataracts may be surgically removed.

Cellulite

Deposits of fat and toxins trapped under the skin which cause the skin to have an orange peel appearance.

Cerumen

Ear wax i.e. waxy substance in the ear. This usually acts as an effective natural repellant for creatures entering the ear.

Chalazion

A painless swelling on the eyelid margin.

Chiropractor

Uses manipulation of the spine to treat disorders of the joints and muscles and their effect on the nervous system.

Chronic Disease List (CDL)

The prescribed minimum benefits for the Chronic Disease List (CDL) differ from the general list of PMB’s in that their minimum treatment is specified in therapeutic algorithms for each condition. The conditions on the PMB CDL are: 1. Addison’s Disease 2. Asthma 3. Bronchiectasis 4. Cardiac Failure 5. Cardiomyopathy disease 6. Chronic Obstructive Pulmonary Disease 7. Chronic Renal Disease 8. Coronary Artery Disease 9. Crohn’s disease 10. Diabetes Insipidus 11. Diabetes Mellitus Type 1 12. Diabetes Mellitus Type 2 13. Dysrrythmias 14. Epilepsy 15. Glaucoma 16. Haemophilia 17. Hyperlipidemia 18. Hypertension 19. Hypothyroidism 20. Multiple Sclerosis 21. Parkinson’s Disease 22. Rheumatoid Arthritis 23. Schizophrenia 24. Systemic Lupus Erythromatosis 25. Ulcerative Colitis

Chronic medicine

Medicine that is usually used or required continuously for longer than 6 months and / or may be life-sustaining.

Chronic Pain

Pain that has been, or is expected to be, present for a long time and persistent.

Cluster headache

Severe, penetrating pain on one side of the head, often accompanied by pain in the eye on the affected side. Often more prominent in men.

Co-payments

Some benefits have a co-payment included whereby the member is required to pay a portion of the treatment e.g. 10% of the chronic prescription cost each month.

Contagious

This usually refers to a disease or condition that is spread by physical contact in terms of being in direct contact, as opposed to indirect exposure such as through water or via air.

Copy Script

The duplicate / invoice of the medicine supplied to the patient and which accompanies the medicine parcel for each dispensing. The medicine name, quantity dispensed, discount given, and price per item plus total price is reflected for the patient’s referrence.

Coryza

This is a common cold.

Cyanocobalamin

Vitamin B12.

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D

Decongestant

An agent, which reduces swelling and congestion of the mucous membrane, thus relieving nasal stuffiness.

Designated Service Provider (DSP)

By using proven and affordable interventions in accordance with medical scheme rules, a Medical Scheme may appoint a Designated Service Provider (DSP) or Provider Group, to provide members with the diagnosis, treatment and supply of medication of Prescribed Minimum Benefit (PMB) conditions. In this case, the member of the Medical Scheme may only use the Service Provider as designated by the Medical Scheme and all costs within the Medical Scheme rules will be paid in full by the Medical Scheme to the DSP. Where a member decides to use the services of a provider that is not a DSP, a co-payment or levy may be imposed on the member by the Medical Scheme, except if the service was involuntarily obtained, i.e. in respect of an emergency condition. A medical condition that is of a sudden and unexpected onset and that requires immediate medical or surgical treatment is considered an emergency condition. Failure to provide this treatment would result in impairment of bodily functions, serious dysfunction of bodily organ or part, of would place the person’s life in serious jeopardy.

Drug Utilisation Review

Drug Utilisation Review (DUR) is a comprehensive review by the pharmacist of your medication, therapy options and alternatives that may be more cost-effective and beneficial to your health and well-being, taking into account your personal circumstances and needs. DUR has an immediate and direct effect on your care by detecting discrepancies before a prescription is dispensed. This is based on the professional judgement of pharmacists. The DUR process involves the pharmacist reviewing your prescription for the following: • Cost effectiveness of the drugs prescribed • Making therapeutic & generic interventions • Excessive or significant under or over usage of medication • Problematic medicine interactions like drug-to-drug interactions • Drug-to-age conflict • Medicine duplication • Insufficient/excessive drug doses • Drug-to-disease contra-indications • Control of substance abuse DUR is designed to contain costs without compromising on the quality of care for you, the patient. The DUR process includes implementing protocols to ensure the best clinical practice and are based on local and international treatment guidelines. Throughout the DUR process no changes are made to your prescription without the permission of your prescribing doctor. The end result should be a cost saving to both you and at the same time to your medical scheme, as well as ensuring that your well-being is not compromised in any way.

Dysentery

An infection of the bowel causing severe diarrhoea.

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E

Ethical/branded product

An original medicine that is marketed and released usually by a major multinational drug company. These products have patent protection usually for a period of 20 years or so to allow the manufacturer to recover research and development costs.

Exceeded benefit

When the patient’s financial limit i.e. benefit as defined by the Medical Scheme has been reached, the excess will for the patient account.

Expectorant

A type of cough remedy that enhances the production of phlegm and is used in the treatment of a productive cough.

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F

Febrile

Feverish.

Flatulence

An excessive build up of gas in the intestinal tract, better known as flatulence. This may be exacerbated by certain food types.

Fracture

A broken bone.

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G

Gargle

Rinsing out the mouth and throat with fluid.

Gastritis

Inflammation of the stomach.

Gastroenteritis

Inflammation of the stomach and intestines.

Generic

A cost effective equivalent medication of a well known branded product, usually substantially cheaper. It has the same active ingredient as the branded product.

Generic Medicine

Generic medicines are the equivalent to the brand-name medicines. They contain the exact same active ingredient, strength and dosage form as the original product.

Gingivitis

Inflammation of the gums: characterised by painful swelling and bleeding as gums begin to draw away.

Grommet

Small plastic tube inserted in the eardrum to equalise middle ear pressure.

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H

Halitosis

Bad or foul breath.

Herpes simplex

Cold sores and fever blisters are caused by herpes simplex virus.

Histamine

Allergic reactions trigger a chemical called histamine to be released. This chemical causes numerous symptoms which may include swelling and inflammation of tissues and itching.

HIV/AIDs

The human immuno-deficiency virus that causes the disease complex known as acquired immuno-deficiency disease.

Hookworm

Small worms (about 10mm long), with hook-like mouthparts.

Humidifier

A device used to increase or control humidity in a room.

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I

Inhalant

These types of treatments or medicines are breathed in through the nose or mouth.

Insomnia

This refers to instances either temporary or more long-term where one is unable to fall asleep or remain asleep for a normal or acceptable period of time.

Intestinal flora

This type of bacteria is present in the intestinal tract and play an essential role in the normal functioning of the intestine.

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K

Kilojoule

This is the measure of a unit of food energy.

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L

Laceration

A wound with jagged edges caused by the tearing of tissue, for example, cuts/lacerations from broken glass.

Large Roundworm

Large worms (up to 20cm long), the size and shape of an earthworm.

Laryngitis

Inflammation of the larynx and vocal cords.

Laxatives

Drugs that increase the frequency and ease of bowel movements, either by stimulating the bowel wall (stimulant laxatives), by increasing the bulk of the bowel contents (bulk laxative), or by lubricating them.

Levies

Some benefits have a levy included whereby the member is required to pay a portion of the treatment i.e a fixed portion i.e. R10 etc. 10% of the chronic prescription cost each month.

Limits

Financial limits are often imposed as part of benefit design e.g. the annual limit for x scheme is R2500. Any treatment outside of this amount will be for the member’s personal account.

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M

Malnutrition

A condition resulting from lack of essential nutrients. Malnutrition may be due to an inadequate or unbalanced diet or to an inability to digest food properly. Symptoms vary according to the cause.

Medical Savings Account (MSA)

A innovative way of managing day to day medical expenses, basically managed by the patient, not the scheme.

Medicine Formulary

A formulary is a list of medicines that have been approved by a medical scheme for the treatment of a specific condition. The medicines on the list are considered safe, clinically appropriate and cost effective for the treatment of the specific condition.

Menaquinone

Vitamin K (manufactured by bacteria in the intestines).

Metabolism

The body releases energy through these chemical processes occurring.

Migraine

Severe, pulsing headache, accompanied by nausea, vomiting or diarrhoea, as well as visual disturbances and sensitivity to light. Often debilitating to those who suffer from them.

MMAP (Maximum Medical Aid Price)

A price set for medicines that have a generic equivalent which the Medical Scheme will cover – any cost which exceeds this maximum amount is for the patient to pay the difference.

Morning sickness

A feeling of nausea, often accompanied by morning vomiting, common in the early weeks of pregnancy.

Mucolytic

Mucus secretions in the airways which are effectively liquefied by mucolytics.

Muscle-relaxant

A drug that relaxes tense muscles or muscle spasms.

Myalgia

Muscle pain.

Myopia

Short-sightedness.

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N

Nebuliser

A device used to convert medicine into a spray which is particularly useful in the treatment of asthma in infants and children.

Neuralgia

Intense or sharp pain along the nerve.

Nutriceutical

NUTRICEUTICAL/NEUTRICEUTICAL: The title “nutraceutical” is a combination of “nutritional” and “pharmaceutical” and refers to foods that act as medicines. This series of letters has presented many references to the healing properties of good nutrition. Nutraceuticals are a refined specific food source that allows concentrated food therapy in a specific area of nutrition. Nutraceuticals can be defined as natural products that are used to supplement the diet by increasing the total dietary intake of important nutrients. This definition includes nutritional supplements such as vitamins, minerals, herbal extracts, antioxidants, amino acids, and protein supplements.

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  O

Obese

This is the term used for individuals who are excessively overweight.

Opportunistic infection

In AIDS patients, infections that occur because of the compromised immune system e.g. thrush are called opportunistic infections.

OTC (Over The Counter)

OTC medicines are commonly known as those products that are available “Over-the-counter”. They do not legally require a doctor’s prescription. These medicines are scheduled from 0 – 2 and are available to the consumer to safely and effectively self-medicate without seeking a doctor’s help or advice. Higher schedules, e.g. Schedule 3 and upwards, need a valid doctor’s prescription. OTC medicines are used widely used to treat minor, less serious conditions that include headaches, the common cold and flu symptoms, coughs, sore throats, minor abrasions, burns, cuts and grazes, diarrhoea, constipation, allergies, minor skin irritations, eye care etc. Over time, consumers have become very well informed, wellness conscious and more confident in treating themselves, hence the increase in reliance and peace of mind in OTC medicine self-use. Generally these medicines are usually not subject to strict controls as they are conspired fairly safe. Please bear in mind that they must be taken or used according to the recommendations on the package insert. Ailment and product information is provided in numerous ways on our website, and include communicating with our Online Pharmacist via email or telephone. The product information is displayed on the website in the form of a package insert and is for your interest and well-being as well as peace of mind in empowering you to responsibly select the product best suited to you and your healthcare needs.

Otitis externa

Outer ear inflammation.

Otitis media

Middle ear inflammation.

Otosclerosis

A middle ear disease which may eventually lead to deafness.

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P

Patent

Patent protection is the legal protection usually granted for a period of approximately 20 years to allow the manufacturer to recover research and development costs. During this time no other manufacturer may copy the drug under patent.

Periodontitis

This refers to disease of the gum.

Pharmacist Advised Therapy (PAT)

Pharmacist Advised Therapy (PAT), is a service that enables a pharmacist to prescribe certain medicine (schedule 0 to 2 substances only) to you without consulting a doctor. This medicine can be paid by the medical scheme, if applicable. Ask your pharmacist to let you know which medicines fall into the PAT category and if your medical scheme will refund you for it. This will save you the cost of consulting the doctor for a minor ailment.

Phylloquinone

Vitamin K (from plant foods).

Physiotherapist

Treats injury and other disease conditions with manipulation, massage, infrared heat treatment and remedial exercise.

Pink eye

Infective conjunctivitis which is contagious and spread through contact. It is an inflammation of the membrane that covers the eyeball and is caused by an allergy or infection.

Pinworm (threadworm)

Tiny, white thread-like worms less than 13mm long; moves when passed in the faeces.

Plaque

Coating of the teeth consisting of mucus, food particles and bacteria. Plaque builds up rapidly without regular, effective brushing, and leads to tooth and gum disease.

Postnasal drip

A discharge of mucus which runs down the back of the nose into the throat.

Pre-authorisation

The process whereby certain medicines, conditions or hospitalisation needs to be authorised prior to embarking on certain therapy. If not pre-authorised, the treatment will not be covered by the Medical Scheme on the chronic benefit.

Pre-certification

The allocation of sufficient funds for chronic medication for a patient i.e. determines the patient’s individual medicine needs and the cost thereof within the benefit allowed by a Medical Scheme.

Presbyopia

Long-sightedness occurring in middle and old age.

Prescribed Minimum Benefits (PMB)

Prescribed Minimum Benefits (PMB) are the minimum benefits which by law must be provided to all Medical Scheme members and include the provision of diagnosis, treatment and medication costs for these medical conditions, as specified in the Regulations of the Medical Schemes Act.

Prescription medicine

Medicine that must be prescribed by a medical practitioner or specialist.

Pyrexia

This refers to fever and a raised body temperature.

Pyridoxine

Vitamin B6.

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R

Retinol

Vitamin A (from animal foods)

Rhinitis

Inflammation (often chronic) of the mucous membranes lining the nasal passage.

Riboflavin

Vitamin B2.

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S

Scab

The hard outer area or “crust” which forms on a wound usually during the healing process.

Scald

Scalds often happen in the kitchen since they are caused by burns which are caused by the steam of hot liquid.

Scheduling Status

Medicine scheduling status, from schedule 0 to 6, is given to all registered medicines according to the active ingredient it contains thereby regulating the use of medicines. The scheduling status of a medicine is determined by and legislated in terms of the Medicines and Related Substances Control Act and is as follows: • Schedule 0 substances may be purchased over the counter (OTC) without a prescription as well as in supermarkets. • Schedule 1 substances may only be purchased without a prescription but from a pharmacy allowing you access to the pharmacist’s advice. • Schedule 2 substances may also be purchased without a prescription from a pharmacist but also allowing you access to the pharmacist’s advice, however are subject to control in terms of dispensing and a schedule 2 register has to be maintained by the pharmacist. • Schedule 3 – 5 substances may only be purchased from a pharmacy with a valid prescription from a doctor or on verbal instruction from a doctor. A verbal prescription only allows a maximum of 7 days treatment to be dispensed by the pharmacy; thereafter the original prescription must be presented to the pharmacist. A prescription must be presented to the pharmacist for dispensing within 30 days from the date the prescription was prescribed by the doctor. Repeatable prescriptions may not exceed 6 months. • Schedule 6 substances may only be purchased from a pharmacy with an original written prescription. In the case of an emergency, the pharmacist may supply the patient with the medicine on a verbal instruction from the doctor, however only with a supply for a maximum of 48 hours and must be followed by an original written prescription within 72 hours. Prescriptions are valid for 30 days only and cannot be repeated.

Sciatica

Pain down the back of the leg.

Sedative

Sedatives suppress or minimise anxiety and result in muscle relaxation. These also aid in insomnia and are used as sleeping tablets.

Sepsis

Infection. Infected tissue is sometimes said to be septic. Severe infection may lead to septic shock.

Shin splints

Athletes, particularly runners, often suffer from shin splints which exhibits in the form of lower leg pain as a result from insufficient training or from overexerting themselves.

Single Exit Price (SEP)

A Single Exit Price is the price set by pharmaceutical manufacturers at which a medicine may be sold including VAT and a logistics fee. Pharmacists may charge a dispensing fee to the SEP of 26% below R100 or R26 above R100 .

Sinus headache

Blocked sinuses are responsible for these dull pressure / sinus headaches. Often treated with antibiotics, and normally goes away after infection has been cleared up.

Sinus headache

Blocked sinuses are responsible for these dull pressure / sinus headaches. Often treated with antibiotics, and normally goes away after infection has been cleared up.

Sleep apnoea

Too much oxygen or insufficient carbon dioxide in the blood A temporary stopping of breathing, possibly because of too much oxygen or too little carbon dioxide in the blood.

Spasm

An uncontrollable contraction of one or more muscles.

Strep throat

A throat infection caused by the streptococcus bacterium; of which the most common and recognised symptom is a sore throat.

Stress fracture

A fracture, usually of a bone in the foot, caused by over-stress of that body part.

Stye

Similar to a boil, a stye is red and painful due to the infection. It is usually found on the follicle of the eyelash or a sebaceous gland of an eyelid.

Swimmer’s ear

Activities which leave the outer ear damp or wet, such as swimming, showering or shampooing one’s hair, sometimes lead to a fungal or bacterial infection of the outer ear, known as swimmer’s ear.

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T

Tapeworm

Segments (rectangular or cylindrical) 10-20mm long. It does not move when passed in the faeces, with a few segments being passed with each stool movement.

Tartar

Brownish deposits around the base of the teeth, usually as a result of poor oral hygiene.

Tension headache

Tenderness in the neck, shoulders and lower back often accompany these headaches. Both sides of the head are affected with pain too.

Thaimin

Vitamin B1.

Tinnitus

This is the ringing, buzzing or roaring noise or sound heard only in the ear of the sufferer. The noise is either intermittent or continues.

Tocopherols

Vitamin E.

Trade Names

TRADE NAMES are used by pharmaceutical companies to identify the medicine they have manufactured. As medicines containing the same active ingredient share the same generic name, for example aspirin, pharmaceutical companies give their medicines trade names, such as Dispirin, to distinguish their medicine from other medicines with the same active ingredient.

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W

Whiplash

An injury to the neck caused by a jerk of the head, as in a car accident.

Whipworm

Worms with a thick front section tapering into a thin, elongated back section. Females are 4-5 cm long; males are a bit shorter.

Whooping cough

A contagious childhood disease characterised by intense and severe coughing spells or bouts.

Nedgroup Scheme Update 2019: Pharmacy Direct is the sole Designated Service Provider for the Nedgroup Hospital Plan

If Hospital Plan members use a non-DSP there is a 25% co-payment which the member will be liable for.

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